Peripheral Bypass Surgery

Peripheral bypass surgery is performed to treat peripheral arterial disease(PAD), a disorder affecting blood flow (narrowing or occlusion by atherosclerotic plaque) through the veins and arteries outside of the heart and brain. Peripheral bypass surgery opens blocked vessels using a peripheral graft, a special tube that reroutes blood around the blockage. Grafts are made of natural human tissue or a synthetic material (such as polytetrafluoroethylene [PTFE] or Dacron). This graft is sewn above and below the diseased artery so that blood flows through the graft.

Board-certified surgeons at Brigham and Women’s Hospital (BWH) are high-volume performers in all types of vascular procedures including peripheral bypass surgery. This experience and their collaboration with a multidisciplinary team of specialists enable our surgeons to handle the most complicated cases, with a range of treatment options that improve the lives of vascular patients throughout the world.

With 47,000 outpatient visits each year, the BWH Heart & Vascular Center is one of the largest in the United States, treating over 7,000 inpatients and performing more than 8,000 procedures annually at our state-of-the-art Shapiro Cardiovascular Center.

Aortobifemoral Bypass for Peripheral Arterial Disease

Aortobifemoral bypass surgery is used to bypass diseased large blood vessels in the abdomen and groin. Synthetic material grafts are more likely to be used than transplanted natural tissue grafts for aortobifemoral surgery, because the blood vessels involved are large in this area.

General anesthesia is used during surgery and will cause you to sleep through the procedure. You may stay in the hospital four to seven days. And you can expect your belly and groin to be sore for several weeks. You will probably feel more tired than usual for several weeks.

You may be able to do many of your usual activities after four to six weeks. But you will likely need two to three months to fully recover, especially if you typically do a lot of physical activities.

Peripheral Leg Bypass Surgery

During a leg bypass surgery, grafts are placed during surgery to carry blood from the femoral artery in the thigh to an artery further down the leg. The graft is stitched into the artery above and below the blockage. This creates a new passage for blood flow. After the graft is in place, the vascular surgeon closes the incisions in the skin with stitches or staples.

Types of Leg Bypass Surgery—Peripheral Grafts

Two types of bypass are used depending upon where your artery is blocked:

  • Distal Bypass: Used for the lower part of your leg. The graft may be your own vein or both your vein and synthetic material.
  • Femoral Popliteal Bypass: Used for the upper part of your leg. The graft may be either your own vein or synthetic material.

A vein from your own legs or arms can be used as a blood vessel graft. Vein grafts work best in long leg blockages that start from your groin and extend below your knee. Man-made (synthetic) grafts are materials that your body easily accepts. These grafts work best on arteries at or above the knee.

Why Have Peripheral Bypass Surgery?

Aortobifemoral bypass surgery is for people who have narrowed or blocked blood vessels (aorta or iliac arteries) in the abdomen and pelvis. Usually the disease must be causing significant symptoms before bypass surgery is considered. Aortobifemoral bypass grafts stay open about 90 percent of the time for at least five years.

Leg bypass surgery is performed to reroute blood around a blockage in the leg to relieve symptoms such as:

  • non-healing wounds over pressure points
  • numbness, weakness or heaviness in muscles when walking
  • pain in the toes or feet
  • gangrene
What You Should Expect

The BWH Heart & Vascular Center is located in the Shapiro building, across the street from BWH’s main 75 Francis Street entrance. The Center brings together the full range of services in one location, fostering seamless and coordinated care for all cardiovascular patients.

If you are having surgery or a procedure, you will likely be scheduled for a visit to the Watkins Clinic in the Shapiro Center for preoperative information and tests.

The day of surgery, your care will be provided by surgeons, anesthesiologists and nurses who specialize in vascular bypass surgery. After your procedure, you will recover in the post-surgical care unit where you will receive comprehensive care by an experienced surgical and nursing staff.

During your surgery, family and friends can wait in the Shapiro Family Center where staff members will provide surgery updates.

Multidisciplinary Care

In addition to our vascular surgeons, patients also benefit from the teamwork of medical cardiologists, interventional cardiologists, cardiovascular imaging experts and radiologists, and anesthesiologists, all experts in cardiovascular disorders. They work alongside nurses, physician assistants, physical therapists, dietitians and social workers to achieve outstanding outcomes for our patients.

Resources

Learn more about peripheral bypass surgery in our health library.

Read more about peripheral vascular disease in our health library.

Visit the Kessler Health Education Library in the Bretholtz Center for Patients and Families to access computers and knowledgeable staff.

Access a complete directory of patient and family services.

Learn about the Watkins Clinic in the Shapiro Center for pre-operative information and tests.

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